“DDQE” to pre-load and validate their quality measurement extracts for over two million members.


HDD has been a tremendous partner helping us look at our data in ways we never had before. DDQE enabled us to make improvements in quality measurement rates, reduce vendor spend, and build the processes to carry these practices on our own in the future,” said Dr. Kyle, Medical Director, Quality.

Over the last 10+ years and after kicking off over 50 new engagements, HDD found a recurring theme and business need among its client base: there is a dire need in a very short amount of time to have analytic ready data. Quality measurement and risk adjustment vendors, whom health plans constantly send vast amounts of data to, are not necessarily focused on data accuracy, trends and completeness and often uncover data issues too late to be properly addressed. Health plans need to address their data quality issues internally prior to these key reporting and revenue optimization initiatives. HDD has developed a systematic, organized, & step by step process to analyze member, provider, claims and pharmacy data before it is sent to any analytic vendor to ensure quality, governance, and completeness. This process and SQL-based rules engine HDD named their “Data Decision Quality Engine” or “DDQE.” DDQE has dramatically helped assess, map, strategize, and improve fundamental data quality which has led to significant rate improvement nationally.

L.A. Care and HDD have run 100+ DDQE rules across its data ensuring the proper data governance and referential integrity providing insight into opportunities for improvement across hundreds of incoming files from delegated plans, labs, state registries and risk-bearing provider networks. DDQE was also used as a foundational comparison between L.A. Care quality measure vendor platforms, during the first year of a large cut-over between the vendors.

About Health Data Decisions

Health Data Decisions is a Massachusetts-based health analytics firm founded in 2008. We offer strategic data solutions for health plans and vendors, bringing broad expertise in data management and analytics, medical economics, risk adjustment, HEDIS, CMS 5-Star, regulatory reporting, and systems strategy. Health Data Decisions brings proven expertise in assessing the effectiveness and efficiency of HEDIS programs and helping plans understand and improve their performance. We provide health plans expert management and/or outsourcing services to help achieve or maintain ratings, accreditation, and performance incentive payment levels.

Please visit us on the web at http://www.healthdatadecisions.com or email tshankle@healthdatadecisions.com to schedule a consultation.

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